Baby’s First Shots: Swaddling And Shushing

The 2 month-old check up may be harder for parents than it is for babies. Getting the first set of shots is anxiety provoking for we moms and dads; no question that it’s unsettling to allow a medical provider to cause our beautiful, new, healthy baby pain. Research has found that the pain and discomfort associated with shots is one of the primary reasons parents “elect not to perform timely vaccination.”

A study published this week affirms two truths. First, structured soothing may be a great tool for families to control crying after discomfort from shots. A group of pediatricians in Virginia used Dr Harvey Karp’s Happiest Baby on the Block 5S’s technique (shushing, swaddling, side positioning, sucking, and swinging/swaying) as an intervention for crying after the 2 and 4 month shots. The technique has been advertised to parents as a way to soothe and comfort fussy and colicky babies in the first few months of life. The researchers found that compared to a control group with no intervention and a group of babies that received a sugary solution for comfort prior to the shots, the 5S technique helped soothe crying and pain more rapidly. Most babies that were swaddled, shushed, swung, and offered a pacifier for sucking stopped crying within only 45 seconds. Second, the great reality is that most babies stop crying within 1 to 2 minutes of getting injections anyway. The study confirmed that, too! In my experience, only rarely does a baby leave clinic still crying. Some of our anxiety about the discomfort as parents can be relieved–we really need to get the word out this is a short process. It’s rare for a baby to cry for even 3 to 4 minutes after their injections.

From a parent perspective, most important task is to find a way that makes you feel you’re providing comfort. Sugary solutions (ie 24% sucrose) have repeatedly been found to provide pain relief for preemies and newborn babies undergoing painful procedures like circumcision and injections. Breastfeeding is a great way to soothe babies after routine injections, too. And although pediatricians previously recommended acetaminophen around the time of shots for pain control, recent research now finds that doing so could decrease the immune response. I routinely recommend no meds for babies on the day they get shots.

Reality is, you may not need to feed your baby sugar and you certainly don’t need to give them medicine when they get shots. In my opinion babies don’t need anything “special” at the time of shots. Your natural comfort and instinct to soothe with swaddling and breastfeeding can be a great comfort. Of course infants clearly don’t like the shot itself, most babies calm within minutes. The study found if you’re comfortable, you can also use the 5S technique to soothe your baby to provide quick soothing.

230 two and four month-old babies were put into 4 groups: 1) no intervention 2) 5S soothing by a resident doctor after shots 3) sugar solution 2 minutes before shots 4) sugar solution before shots and 5S soothing by a doctor after shots. Over 70% of babies were 2 month-olds during the study (getting their first round of shots) and over 80% of babies were African-American. None of the babies provided the 5S intervention were comforted by their parents after shots, rather by a pediatric resident trained in using the 5S technique.

Researchers scored babies every 15 seconds for signs of pain using a standardized scale called the Modified Riley Pain Score. The pain score evaluates verbal/vocal score (no cry to high-pitched cry), body movements (calm to thrashing), and facial expressions (calm smiling to “full cry expression”). Babies received scores from 0 to 9 at each 15-second interval after shots.

All intervention groups soothed more quickly than the group of babies with no intervention. But even in the group with no intervention (presumedly handed back to a parent), nearly all babies (over 80%) had minimal pain scores (<2 on the Riley scale) after 90 seconds.

Overall, the study concluded using the 5S technique provided decreased pain scores and decreased crying time in 2 and 4-month old babies after routine immunization.

The takeaway is that infants do a beautiful job calming down after receiving routine 2 and 4-month shots. And that the 5S technique helps babies soothe more rapidly after shots. Talk with your baby’s pediatrician if you’re concerned about the discomfort associated with infant immunizations and tell me, how long did your baby fuss after shots? And what did you do that worked well to soothe (both you and) your newborn?

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11 Comments to “Baby’s First Shots: Swaddling And Shushing”

Funny, I guess I’m hard hearted, but I wasn’t horribly bothered by my son’s shots. I mean yes, I hate to see him cry, but it’s necessary, and when he was that little, the pain was over almost before he comprehended it enough to react. AND he stopped crying in literally a few seconds. Now it takes him a little longer, but it’s still well under a minute. I think that may partly be because of my cold heart… I’m not so overwrought myself so I can focus on snuggling him.

Dear SMD, I am a believer of 5s, partially because I read and applied it successfully to my first born and second, partly because its an Indian tradition, to swaddle babies until they gain neck control. Mine would never stay in the swaddle for more than a few hours, and then pull a Houdini on us, with the cotton blanket lying undone or manage to get their limbs out.
An observation, from my untrained eye would be, swaddled kids dont get startled in sleep as much as non-swaddled kids in their first few months.
The interesting part is “shushing” never goes away. My kids, now 4 and 8 still respond to my shushing and hugs, when they are in pain and/or crying, and are growing up to be wholesome, happy and healthy.

The shots don’t bother me at all either. This time (third child) my baby screamed hours after the shots. That was scary and I am petrified about the next round. With my other 2 kids they cried for a few seconds and were a little fussy for a day or two.

[…] to help ease the discomfort of shots in children. For young babies there is something known as the 5 S’s technique, which Dr. Swanson explains in great detail on her blog Seattle Mama Doc. Then yesterday I read about some new research findings that suggest a sugar solution given […]

My little girl just got her two month shots today. She cried and screamed for about five minutes after and I started to breast feed her immediately after which calmed her down and she was able to sleep for about 45 minutes, however when she woke up she immediately started crying and screaming again. So I wrapped her in her recieving blanket and breast fed her again till she fell asleep, but if I moved even the slightest she would start to scream and cry all over. This patern went on for about four hours till she fell into a deeper sleep that’s lasted for about two hours so far.

My wife called me while I was still @ work sounding petrified. I got really worried n had to rush back home to find my little girl crying n screaming like I’ve never seen her do. It was disheartening. She told me it was d shots and I came online to see what other people have said about it, while doing that she gave her a warm shower n she slept off in less than 60 seconds. Still waiting for her to wake up n hoping she wouldn’t cry. You mothers are really strong. God bless you all.

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Seattle Children’s provides healthcare for the special needs of children regardless of race, color, creed, national origin, religion, sex (gender), sexual orientation or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.